女性脊髄損傷患者の尿路管理に関する考察 - 28症例の検討 -

Abstract

1980年1月からの5年間に星ヶ丘厚生年金病院泌尿器科で尿路管理を行った女性脊髄損傷症例28症例について検討した.1)退院時排尿方法は, catheter free 11例(39.3%), 間欠的自己導尿法3例(10.7%), 介助者による間欠的導尿法1例(3.6%), 膀胱留置カテーテル13例(46.4%)であった.2)女性用の有効な集尿器や尿失禁防止器具のないことおよび下位胸髄損傷や腰髄損傷であってもADLレベルの低い症例が少なからず存在した.3)対麻痺患者においては, toilet activitiesが可能な症例に対して, 今後間欠的自己導尿法の適用が増加していくと思われる.4)頸髄損傷症例においては80%がやむなく膀胱留置カテーテルとなっていた

Most of the literature about the urological management of spinal cord injury patients is on male patients, and the method of the urological treatment for male spinal cord injury patients is often not useful for female patients. A clinical survey was done on 28 female neurogenic bladder patients after spinal cord injury treated at our Hospital between January, 1980 and January, 1985. At discharge, 11 patients (39.3%) were catheter free, 3 (10.7%) were managed by clean intermittent self catheterization, 1 (3.6%) was managed by clean intermittent catheterization by a helper, and 13 (46.4%) were on indwelling catheters. One of the main reasons that prevents female spinal cord injury patients from becoming catheter free is that there are no effective external collecting devices or devices to prevent urinary incontinence for female neurogenic bladder patients. Another reason is that some female patients can not obtain a high enough ADL level for toilet activities by rehabilitation in spite of lower thoracic or lumbar lesions.